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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred eighty-three women with chronic pelvic pain were referred to a multidisciplinary chronic pelvic pain clinic after negative laparoscopy. One hundred twenty-two of them completed a thorough medical and psychologic evaluation and were followed for a minimum of six months after completion of therapy. Occult somatic pathology was diagnosed in 57 women (47%), including 19 in whom coexistent psychopathology was diagnosed. Myofascial pain was the most common somatic diagnosis, followed by atypical cyclic pain (dysmenorrhea or mittelschmerz); gastroenterologic, urologic and infectious diseases; and pelvic vascular congestion. No plausible somatic etiology was apparent in the remaining 65 (53%) of the 122 referrals. Nongynecologic somatic pathology accounted for 34 (29%) and gynecologic pathology for 23 (19%) of the referrals, only 6 (5%) of whom ultimately required hysterectomy. Women with a somatic diagnosis were found to be significantly older than the remainder of the referral population. Long-term symptomatic improvement or resolution of pain was obtained in 43 (75%) of the 57 patients with somatic diagnoses. Coexistent psychopathology was found to correlate with a poorer long-term prognosis. Our findings underscore the importance of a multidisciplinary approach to evaluating and treating chronic pelvic pain in women and confirm that hysterectomy is indicated in this setting only rarely.
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PMID:Nongynecologic somatic pathology in women with chronic pelvic pain and negative laparoscopy. 183 Jan 2

Myofascial pain as a cause of chronic pelvic pain with or without pelvic organ pathology is well-documented in the literature. Causes of this pain are multifactorial, including specific pelvic organ pathologies, neuromuscular disorders, and psychologic causes. Management of this myofascial component of chronic pelvic pain involves a multidisciplinary approach including physicians, physical therapists, neurologists, and psychiatrists. Treatment strategies, including behavioral management, medications, physical therapy, trigger point injections, neuromodulation, botulinum toxin injection, and other lesser known treatment modalities, are discussed in detail in this article.
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PMID:Myofascial dysfunction associated with chronic pelvic floor pain: management strategies. 1789 26

Chronic pelvic pain in men has often been misdiagnosed as prostatitis. After excluding serious or acute urological, neurological or colorectal conditions, it is essential to approach these patients with a much more comprehensive criteria. Thoughtful interview and methodical physical examination can very often reveal pelvic floor muscle dysfunction, Myofascial pain syndromes, Functional Somatic Syndrome/Central Sensitization Syndromes and/or psychosocial distress. One must be aware that many of these syndromes frequently overlap. Acknowledgement of these conditions and validation of both their physical and psychological distress is paramount to creating trust and confidence in the patient. These are the cornerstones for empowerment and self-care required in the management of chronic pelvic pain.
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PMID:Male Pelvic Pain: Beyond Urology and Chronic Prostatitis. 2671 51